Medicaid expansion opponents, backers testify to Iowa panel

DES MOINES, Iowa (AP) — Plenty of people showed up but most weren’t able to speak at a House hearing Tuesday evening equally divided between supporters and opponents of a Medicaid expansion plan.

Three-quarters of the 72 people signed up to testify before the Republican-controlled House budget committee identified themselves as supporters of the Senate bill that would expand Medicaid in Iowa. Only 32 of the 72 people had a chance to speak, 15 in opposition and 17 in support.

The measure approved by the Senate would add from 130,000 to 180,000 people with incomes at or below 138 percent of the poverty line to the state’s Medicaid rolls. Under the Affordable Care Act, the federal government will pick up the entire cost of the new enrollees for three years, before ratcheting down to 90 percent.

“Medicaid expansion is a win-win-win proposition,” said Kirk Norris, a supporter and president of the Iowa Hospital Association. “Iowa taxpayers save money, business, state and local government save money and most importantly 150,000 Iowans receive insurance.”

Representatives from groups including the Iowa Federation of Labor, Child and Family Policy Center, AARP and the Iowa Association of Counties spoke in favor of expansion.

Ken Sagar, president of the Iowa Federation of Labor, said Medicaid expansion would promote job creation.

“As more people are covered and receive care, hospitals and providers will create jobs in construction and other infrastructure improvements,” he said.

The first five speakers opposed the plan, saying it was wrong to expand Medicaid amid the nation’s budget problems.

“Once you given into a state-based program that is 100 percent federally funded, this burden is going to fall back on the state. There’s no such thing as free, federal money,” said Ed Brown, chief executive officer of The Iowa Clinic, a health care partnership.

Other groups, including the Iowa Taxpayers Association, Des Moines Orthopedic Surgeons and Americans for Prosperity, a nonprofit group promoting limited government, spoke against expansion.

Some physicians also backed Republican Gov. Terry Branstad’s plan, called Healthy Iowa, which offers more limited benefits to an estimated 89,000 residents.

“Getting people to take ownership of their health is critical ... It encourages members to participate in preventative measures so we catch diseases earlier and saves Iowans money in the long run,” said Dr. Christi Taylor, a primary care physician from West Des Moines.

Healthy Iowa would need federal approval. According to the bill, participants would have access to a primary care doctor within 30 minutes or 30 miles of their home. Participants would be responsible for contributions, though they could seek to avoid those due to hardships.

The state cost for Healthy Iowa is estimated at $162 million per year, with the funding coming from the state general fund, local property taxes and other sources. The plan would rely on $225 million annually from the federal government.

The hearing was limited to 90 minutes, but was allowed to run 20 minutes over as lawmakers in attendance spent that time introducing themselves.